Knotless lateral row implant

ABSTRACT

An anchoring system includes an anchor including an anchor body and a distal member located at a distal end of the anchor body, the distal member having a suture receiving aperture; and an implant delivery device, comprising: a cannulated outer shaft, the cannulated outer shaft configured to engage a proximal end of the anchor body for driving the anchor into a bore; and an inner shaft slidably received in the cannulated outer shaft, wherein a distal end of the inner shaft is extendable distally beyond a distal end section of the cannulated outer shaft such that, when the cannulated outer shaft is engaging the proximal end of the anchor body, the distal end of the inner shaft is extendable through the anchor body to a distance beyond the distal end of the anchor body to engage a suture located within the suture receiving aperture, wherein the anchoring system is configured such that the suture can be tensioned at a location within the bore distal from the anchor body before the anchor body is implanted within the bore.

CLAIM OF PRIORITY

This application claims the benefit of U.S. Provisional PatentApplication Ser. No. 62/510,963, filed on May 25, 2017, the benefit ofpriority of which is claimed hereby, and which is incorporated byreference herein in its entirety.

FIELD OF THE DISCLOSURE

The present subject matter relates to securing a suture to a bore, suchas in a portion of bone.

BACKGROUND

In the human body, tissue can require repair. For example, a tear in arotator cuff can require surgical repair of the rotator cuff. Surgeonsoften use suture anchors to secure bone and tissue in place during asurgical procedure. A suture is connected to the anchor, which istypically implanted in bone.

OVERVIEW

In a first example, an anchoring system can include an anchor includingan anchor body and a distal member located at a distal end of the anchorbody, the distal member having a suture receiving aperture; and animplant delivery device, comprising: a cannulated outer shaft, thecannulated outer shaft configured to engage a proximal end of the anchorbody for driving the anchor into a bore; and an inner shaft slidablyreceived in the cannulated outer shaft, wherein a distal end of theinner shaft is extendable distally beyond a distal end section of thecannulated outer shaft such that, when the cannulated outer shaft isengaging the proximal end of the anchor body, the distal end of theinner shaft is extendable through the anchor body to a distance beyondthe distal end of the anchor body to engage a suture located within thesuture receiving aperture, wherein the anchoring system is configuredsuch that the suture can be tensioned at a location within the boredistal from the anchor body before the anchor body is implanted withinthe bore.

In example 2, the anchoring system of example 1 can include aconfiguration such that a suture located in the suture receivingaperture is driven distally beyond the distal member.

In example 3, the anchoring system of example 2 can include the suturereceiving aperture including a pair of openings on opposing sides of thedistal member defining an eyelet.

In example 4, the anchoring system of any of examples 2 or 3 can includethe inner shaft including a fork on the distal end of the inner shaft,the fork configured to hold the suture as the distal end of the innershaft is extended beyond the distal end of the distal member.

In example 5, the anchoring system of example 4 can include the forkbeing a two-pronged fork.

In example 6, the anchoring system of any of examples 2-5 can includethe anchoring system being configured so that the suture is at a properlocation to be tensioned when the distal end of the inner shaft is on abottom surface of the bore and holding the suture at a distal positon ofthe bore.

In example 7, the anchoring system of any of examples 1-6 can includethe suture receiving aperture including a slot in the distal member.

In example 8, the anchoring system of example 7 can include the slotbeing an L-shaped slot with an opening on a side of the distal memberdefining a first leg of the L-shaped slot and a longitudinally runningslot in the distal member defining a second leg of the L-shaped slot.

In example 9, the anchoring system of example 8 can include a distal endof the distal member being closed and when the inner shaft is extendedat least a portion of the inner shaft covers the opening on the side ofthe distal member so as to secure the suture within the distal member.

In example 10, the anchoring system of example 9 can include theanchoring system being configured such that the suture located in thesuture receiving aperture is not driven distally beyond the distalmember.

In example 11, the anchoring system of any of examples 1-10 can includethe distal member being rotatable relative to the anchor body.

In example 12, the anchoring system of any of examples 1-11 can includeanchor body including a threaded outer surface.

In example 13, the anchoring system of example 12 can include the distalend section of the cannulated outer shaft engaging the proximal end ofthe anchor body for rotating the anchor body with the cannulated outershaft.

In example 14, a method for securing a suture to a bore can include:mounting an anchor to an implant deliver device, the anchor including ananchor body and a distal member located at a distal end of the anchorbody; loading a suture into the distal member of the anchor; positioninga portion of the suture distally past a distal end of the anchor body;positioning the anchor at a bore so that the portion of the suturedistally past the distal end of the anchor body is located at or near abottom of the bore while the anchor by is above the bore; tensioning thesuture; and driving the anchor body into the bore to secure the suture.

In Example 15, the method of example 14 can include the distal memberincluding a suture receiving aperture and the suture loaded through thesuture receiving aperture.

In example 16, the method of any of examples 14-15 can include theimplant delivery device includes a cannulated outer shaft, thecannulated outer shaft including a distal end configured to engage aproximal end of the anchor body for driving the anchor into a bore; andan inner shaft slidably received in the cannulated outer shaft, whereina distal end of the inner shaft is extendable distally beyond the distalend of the cannulated outer shaft such that, when the distal end of thecannulated outer shaft is engaging the proximal end of the anchor body,the distal end of the inner shaft is extendable through the anchor bodyto a distance beyond the distal end of the anchor body to engage thesuture.

In example 17, the method of example 16 can include the anchoring systembeing configured such that the suture is driven distally beyond thedistal member before the anchor is positioned at the bore.

In example 18, the method of example 17 can include the inner shaftincluding a fork on the distal end of the inner shaft, the forkconfigured to hold the suture as the distal end of the inner shaft isextended beyond the distal end of the distal member.

In example 19, the method of any of examples 14-18 can include thedistal member including a slot as a suture receiving aperture, whereinthe slot is an L-shaped slot with an opening on a side of the distalmember defining a first leg of the L-shaped slot and a longitudinallyrunning slot in the distal member defining a second leg of the L-shapedslot.

In example 20, the method of example 19 can include a distal end of thedistal member being closed and when the inner shaft is extended at leasta portion of the inner shaft covers the opening on the side of thedistal member so as to secure the suture within the distal member.

These examples can be combined in any permutation or combination. Thisoverview is intended to provide an overview of subject matter of thepresent patent application. It is not intended to provide an exclusiveor exhaustive explanation of the invention. The detailed description isincluded to provide further information about the present patentapplication.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a perspective view of an anchoring system, according to oneembodiment.

FIG. 2 shows a cross section view of portions of the anchoring system ofFIG. 1, according to one embodiment.

FIG. 3 shows a perspective view of a distal member of an anchor,according to one embodiment.

FIG. 4 shows a perspective view of the anchoring system of FIG. 1,according to one embodiment. FIG. 5 shows a perspective view of theanchoring system of FIG. 1, according to one embodiment.

FIG. 6 shows a perspective view of the anchoring system of FIG. 1,according to one embodiment.

FIG. 7 shows a perspective view of an anchoring system, according to oneembodiment.

FIG. 8 shows a perspective view of the anchoring system of FIG. 7,according to one embodiment.

FIG. 9 shows a perspective view of the anchoring system of FIG. 7,according to one embodiment.

FIG. 10 shows a perspective view of an implanted anchor, according toone embodiment.

Corresponding reference characters indicate corresponding partsthroughout the several views. Elements in the drawings are notnecessarily drawn to scale. The configurations shown in the drawings aremerely examples, and should not be construed as limiting the scope ofthe invention in any manner.

DETAILED DESCRIPTION

During a surgical process, such as a rotator cuff repair surgery, asurgeon can prepare one or more bores in a bone. The surgeon can affixsutures to the bone at each bore. For each hole, the surgeon can deployan anchor with an anchor body into the bore, which can secure the suturebetween the threads of the anchor body and the wall of the bore. Thedevices and methods discussed herein pertain to the anchor, the elementsused in an implant delivery device that can deploy the anchor, and amethod of deploying the anchor.

FIG. 1 shows a perspective view of an anchoring system 100, according toone embodiment. The anchoring system 100 can include an anchor 110including an anchor body 112 and a distal member 114 located at a distalend 116 of the anchor body 112. The distal member 114 can include asuture receiving aperture 118 to receive one or more suture 125. Thedistal member 114 can be rotatable relative to the anchor body 112.

The anchoring system 100 can further include an implant delivery device150. The implant delivery device 150 can include a cannulated outershaft 152 and an inner shaft 154 slidably received in the cannulatedouter shaft 152.

Referring now also to FIG. 2, which shows a cross section view ofportions of the anchoring system 100 showing further details, the anchorbody 112 can include a cannulated body defining an inner bore and athreaded outer surface 113. Here, the cannulated outer shaft 152 caninclude a distal end section 155 configured to engage a proximal end 117of the anchor body 112 for rotatably driving the anchor body 112 into abore via the threaded outer surface 113. Since the distal member 114 isrotatable relative to the anchor body 112, the distal member 114 doesnot rotate as the anchor body 112 is threadably implanted. Thecannulated outer shaft 152 includes a shoulder 153 on the distal endsection 155 which can abut the proximal end 117 of the anchor body 112when the anchor body 112 is fully seated on the implant delivery device150.

As will be explained in further detail below, a distal end 156 of theinner shaft 154 is extendable distally beyond the distal end section 155of the cannulated outer shaft 152 such that, when the distal end section155 of the cannulated outer shaft 152 is engaging the proximal end 117of the anchor body 112, the distal end 156 of the inner shaft 154 isextendable through the anchor body 112 to a distance beyond the distalend 116 of the anchor body 112 to engage the suture 125 located withinthe suture receiving aperture 118. Thus, the anchoring system 100 isconfigured such that the suture 125 can be tensioned at a locationwithin a bore distal from the anchor body 112 before the anchor body 112is implanted within the bore. This allows for better and easier implantsand allows a surgeon to have the desired tension in the suture beforethe anchor is implanted.

In this example, the inner shaft 154 can include a fork 157, such as atwo-pronged fork, on the distal end 156 of the inner shaft 154. The fork157 can be configured to hold the suture 125 as the distal end 156 ofthe inner shaft 154 is extended beyond a distal end 115 of the distalmember 114.

FIG. 3 shows a perspective view of the distal member 114 of the anchor110, according to one embodiment. In this example, the suture receivingaperture 118 of the distal member 114 includes a pair of openings 324 onopposing sides of the distal member 114 defining an eyelet to receivethe suture therethrough. The distal member 114 includes a bore 322extending from the distal end to a proximal end 319. A lip 320 atproximal end 319 can be fitted into an indent 321 (FIG. 2) of the anchorbody 112 to hold the distal member 114 in place. One or more slots 326can extend longitudinal through the distal member 114 to allow thedistal bore 322 to be flexible while the inner shaft 154 is deployedengaging the sutures 125 from the aperture 118.

FIGS. 1 and 4, 5, 6, show an example use of the anchoring system 100. InFIG. 1, the one or more sutures 125 are loaded through the suturereceiving aperture 118. In FIG. 4, a bore 302 has been prepared in abone 304 to receive the anchor 110 to attach a tissue 306 to the bone304. The inner shaft 154 is deployed such that it engages the sutures125 within the suture receiving aperture 118 and then holds and drivesthe sutures 125 out distally past the distal end 115 of the distalmember 114.

In FIG. 5 the inner shaft 154 has been introduced into the bore 302 withthe inner shaft 154 still deployed as in FIG. 4 until the distal end ofthe inner shaft 154 bottoms out on a bottom surface of the bore 302.Anchor body 112 is positioned at the top surface of the bore 302, whilethe sutures 125 at the end of the inner shaft 154 are located near or atthe bottom of the bore 302. The sutures 125 can then be tensioned asdesired. Thus, the anchoring system 100 is configured so that thesutures are at a proper location within the bore 302 so as to betensioned before the anchor is implanted and when the distal end of theinner shaft is on a bottom surface of the bore and holding the suturesat a distal location within the bore.

Once, the sutures 125 are properly tensioned, the implant deliverydevice 150 can rotatably implant the anchor body 112 until the distalend of the anchor body is flush with the bone 304 surface, as shown inFIG. 6. Thus, the sutures 125 are captured between the bore wall and theouter surface of the anchor body 112. The implant delivery device isthen removed.

FIG. 7 shows a perspective view of an anchoring system 700, according toone embodiment. System 700 includes many features similar to system 100discussed above and certain details will be omitted. Here, the anchoringsystem 700 can include an anchor 702 to be implanted by the implantdelivery device 150.

The anchor 702 includes an anchor body 712 with a threaded outersurface, similar to anchor body 112, discussed above. The anchor furtherincludes a distal member 714. Instead of an eyelet-like aperture, thesuture receiving aperture of distal member 714 can include a slot 718 inthe distal member 714. Slot 718 can include an L-shaped slot with anopening 719 on a side of the distal member defining a first leg of theL-shaped slot and a longitudinally running slot 720 in the distal memberdefining a second leg of the L-shaped slot. The open design allows forquick loading of the suture 125 which can be slipped through the opening719 into the longitudinal slot 720.

Referring now also to FIG. 8, a distal end 715 of the distal member 714is closed such that when the inner shaft 754 is extended into the distalmember 714, at least a portion of the inner shaft 754 covers the opening719 on the side of the distal member 719. This secures the suture 125within the distal member 714 at or near a distal portion of the distalmember 714. The distal member 714 is longer than the distal member 114discussed above, and the suture is now positioned such that it is notnecessary to drive the suture distally beyond the distal member 714.

In FIG. 9, the anchor 700 is pushed into the bore 302 until the distalend of the anchor body 712 is at the top surface of the bore 302. Atthat time the sutures 125 in the distal member 714 are at or near abottom of the bore 302. The sutures 125 can then be tensioned and theanchor body 712 is driven into the bore until it is fully seated andthen the implant delivery device 150 is removed, as shown in FIG. 10.

In an example, the anchor body 712 is cannulated and the distal member714 at least partially enters the cannulated anchor body 712 as theanchor body 712 is driven into the bore 302 over the distal member 714.

Again, for the anchoring systems discussed herein, the systems areconfigured such that a suture can be tensioned at a location within thebore distal from the anchor body before the anchor body is implantedwithin the bore. This allows for better and easier implants and allows asurgeon to have the desired tension in the suture with the suture in thedesired location within the bore before the anchor is implanted.Moreover, the system allows for the ability to tension and fixatelateral row anchors without needing knots in a rotator cuff repair.

Additional Notes

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

All publications, patents, and patent documents referred to in thisdocument are incorporated by reference herein in their entirety, asthough individually incorporated by reference. In the event ofinconsistent usages between this document and those documents soincorporated by reference, the usage in the incorporated reference(s)should be considered supplementary to that of this document; forirreconcilable inconsistencies, the usage in this document controls.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In the appended claims, the terms “including” and“in which” are used as the plain-English equivalents of the respectiveterms “comprising” and “wherein.” Also, in the following claims, theterms “including” and “comprising” are open-ended, that is, a system,device, article, or process that includes elements in addition to thoselisted after such a term in a claim are still deemed to fall within thescope of that claim. Moreover, in the following claims, the terms“first,” “second,” and “third,” etc. are used merely as labels, and arenot intended to impose numerical requirements on their objects.

What is claimed is:
 1. An anchoring system, comprising: an anchorincluding an anchor body and a distal member located at a distal end ofthe anchor body, the distal member having a suture receiving aperture;and an implant delivery device, comprising: a cannulated outer shaft,the cannulated outer shaft configured to engage a proximal end of theanchor body for driving the anchor into a bore; and an inner shaftslidably received in the cannulated outer shaft, wherein a distal end ofthe inner shaft is extendable distally beyond a distal end section ofthe cannulated outer shaft such that, when the cannulated outer shaft isengaging the proximal end of the anchor body, the distal end of theinner shaft is extendable through the anchor body to a distance beyondthe distal end of the anchor body to engage a suture located within thesuture receiving aperture, wherein the anchoring system is configuredsuch that the suture can be tensioned at a location within the boredistal from the anchor body before the anchor body is implanted withinthe bore.
 2. The anchoring system of claim 1, wherein the anchoringsystem is configured such that a suture located in the suture receivingaperture is driven distally beyond the distal member.
 3. The anchoringsystem of claim 2, wherein the suture receiving aperture includes a pairof openings on opposing sides of the distal member defining an eyelet.4. The anchoring system of claim 2, wherein the inner shaft includes afork on the distal end of the inner shaft, the fork configured to holdthe suture as the distal end of the inner shaft is extended beyond thedistal end of the distal member.
 5. The anchoring system of claim 4,wherein the fork is a two-pronged fork.
 6. The anchoring system of claim2, wherein the anchoring system is configured so that the suture is at aproper location to be tensioned when the distal end of the inner shaftis on a bottom surface of the bore and holding the suture at a distalpositon of the bore.
 7. The anchoring system of claim 1, wherein thesuture receiving aperture includes a slot in the distal member.
 8. Theanchoring system of claim 7, wherein the slot is an L-shaped slot withan opening on a side of the distal member defining a first leg of theL-shaped slot and a longitudinally running slot in the distal memberdefining a second leg of the L-shaped slot.
 9. The anchoring system ofclaim 8, wherein a distal end of the distal member is closed and whenthe inner shaft is extended at least a portion of the inner shaft coversthe opening on the side of the distal member so as to secure the suturewithin the distal member.
 10. The anchoring system of claim 9, whereinthe anchoring system is configured such that the suture located in thesuture receiving aperture is not driven distally beyond the distalmember.
 11. The anchoring system of claim 1, wherein the distal memberis rotatable relative to the anchor body.
 12. The anchoring system ofclaim 1, wherein the anchor body includes a threaded outer surface. 13.The anchoring system of claim 12, wherein the distal end section of thecannulated outer shaft can engage the proximal end of the anchor bodyfor rotating the anchor body with the cannulated outer shaft.
 14. Amethod for securing a suture to a bore, the method comprising: mountingan anchor to an implant deliver device, the anchor including an anchorbody and a distal member located at a distal end of the anchor body;loading a suture into the distal member of the anchor; positioning aportion of the suture distally past a distal end of the anchor body;positioning the anchor at a bore so that the portion of the suturedistally past the distal end of the anchor body is located at or near abottom of the bore while the anchor body is above the bore; tensioningthe suture; and driving the anchor body into the bore to secure thesuture.
 15. The method of claim 14, wherein the distal member includes asuture receiving aperture and the suture loaded through the suturereceiving aperture.
 16. The method of claim 14, wherein the implantdelivery device includes a cannulated outer shaft, the cannulated outershaft including a distal end configured to engage a proximal end of theanchor body for driving the anchor into a bore; and an inner shaftslidably received in the cannulated outer shaft, wherein a distal end ofthe inner shaft is extendable distally beyond the distal end of thecannulated outer shaft such that, when the distal end of the cannulatedouter shaft is engaging the proximal end of the anchor body, the distalend of the inner shaft is extendable through the anchor body to adistance beyond the distal end of the anchor body to engage the suture.17. The method of claim 16, wherein the anchoring system is configuredsuch that the suture is driven distally beyond the distal member beforethe anchor is positioned at the bore.
 18. The method of claim 17,wherein the inner shaft includes a fork on the distal end of the innershaft, the fork configured to hold the suture as the distal end of theinner shaft is extended beyond the distal end of the distal member. 19.The method of claim 16, wherein the distal member includes a slot as asuture receiving aperture, wherein the slot is an L-shaped slot with anopening on a side of the distal member defining a first leg of theL-shaped slot and a longitudinally running slot in the distal memberdefining a second leg of the L-shaped slot.
 20. The method of claim 19,wherein a distal end of the distal member is closed and when the innershaft is extended at least a portion of the inner shaft covers theopening on the side of the distal member so as to secure the suturewithin the distal member.